#my fav psych appointment was when there was a trainee present who knew more than the man WHO HAS BEEN A CONSULTANT FOR 20 YEARS

[somecunttookmyurl]

sorry if there was another part of this post/those tags that i didn’t see but… i don’t think that doctor was trying to say that doctors know more about drugs than pharmacists do?

i’m an md also, i graduated from medical school a few years ago. and that person is right. we do learn about pharmacology and drug mechanisms and interactions in medical school. at my school (which was broken up into long blocks by body system), this was all integrated into everything else we were learning, meaning it was on every test. and it’s continued to be on every test i’ve taken since graduating. the point isn’t that we know more or even nearly as much as pharmacists about pharmacology, but that we know enough that someone who completely ignores the concept of drug interactions or the idea that different patients may metabolize certain drugs differently is a bad doctor. and i’m sorry that you’ve run across so many of them

the thing about medicine is that there is so much to know about human anatomy and physiology and disease that it’s basically impossible for any one person to know it all. medical school lays the groundwork, but there’s a reason we specialize, and spend 3-7 years in additional training in our particular field. it’s important to know what you don’t know (which is a lot, no matter what kind of doctor you are or how long you’ve been practicing). that means consulting with pharmacists when prescribing a new med or changing a dose whenever possible, just like you’d consult, say, a nephrologist when treating a patient with kidney disease. but when there isn’t a good pharmacist available, it means looking up that information yourself. i may not remember every single drug that interacts with warfarin, for example, off the top of my head, but i sure as hell know that it’s a long list and i better check everything else a patient is taking before prescribing it

anyway, good pharmacists are an incredible resource and i wish we had more of them at my hospital. and if you can’t admit that there are things you don’t know, medicine is not the field for you

yeah i've had like. no joke. 2 good doctors in 31 years. and one of them i don't even get to see again it was a one-off. but i am surgically attached to my GP until one of us dies and by god i hope i go first.

(incidentally those 2 doctors are the only ones i've ever met who even knew that differing drug metabolism on different pathways was even a thing like at all. my old psych straight up said "never heard of that, don't think that's true" even when i was presenting him with literal medical journals to the contrary like okay buddy good talk let's never do this again. i wish so much this was an uncommon experience bc i for one am tired of giving the TED talk)

readmore bc this got long

the fact you guys don't learn stuff to the same depth as pharmacists was really like my entire point. i mean, sure, you have some knowledge on it but normally pretty limited to within whatever field you practice. you've only got a limited number of brain cells. if you did have all that knowledge then pharmacy wouldn't exist as a separate degree in the first place.

so a doc coming onto that like "oh we do know side effects and get tested on interactions" is uh. i mean do you? a little, sure, but there's a limit to that knowledge by design. it's really the pharmacists who know, you know? they're the experts on it, and it kinda struck me as "i did a bit of training on this so i know everything" which is an attitude i encounter.... a lot with doctors, sadly. along with the assumption a patient can never know anything about their condition/have any input or ideas of any value/that there may be gaps in their own knowledge.

[also along with complete lack of intellectual curiosity which always baffled me like "welp, don't know what that is goodbye forever" do you not... want to know? not even a little bit? god why are you even here. if all you wanted to do was flowcharts and tick boxes there are plenty of careers in the data entry field. not quite sure why you went to medical school my man]

you sound like a good doctor. hold onto that. sadly you're more the exeption than the norm, as pretty much anybody with a chronic illness or unusal presentation/response can attest. also women, and POC.

if you've got it in you to keep at it without having a nervous breakdown (rather have you in the field than out of it babes) absolutely chew out any other doctor you catch acting like a Supreme Unquestionable Being Who Can Never Be Wrong though.

honestly? i think, genuinely, most do start out like you (you said you only graduated a few years ago right? so you're still new really) and... at some point along the way they become fucking insufferable.

i don't know if it's burnout bc it's a stressful job, or if having power over the health & wellbeing over other people eventually goes to your head, or you get stuck in "what i learned 20 years ago is still unquestionable" or "i've been doing this for years pfff i don't need to check things anymore" complacency or what but there is for sure SOMETHING that changes in a whole lotta doctors. hold on to how you practice now. be one of the few who STAY like that 10, 20, 30 years from now. please. stay curious, stay cautious, stay sharp.

i don't hate doctors (i say it jokingly, true, but don't take it personally) but i have absolutely met enough of them that don't listen, or check, or investigate that i heavily side-eye a new one until they demonstrate otherwise. you're listening to me and working with me and checking things? cool! i'm still gonna double-check anyway because even good doctors make mistakes,

but a good good doctor doesn't take offence at that anyway. i mean. it's my health you're in charge of here. remaining alive and not hospitalised is generally preferable.

hey, maybe it's a bit harsh to judge from a couple tags but coming onto a post saying that pharmacists are the real drug nerds here and doctors have limited knowledge about that (with a heavy dose of complacency a lot of the time, tbqh) so please make sure stuff is checked with "we do know about interactions we get tested on it" sent up a HUGE "i can't admit when there are gaps in my knowledge and can't handle being questioned" red flag.